Journal List > J Rheum Dis > v.19(4) > 1063977

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Song, Kim, Lee, Lee, Hong, Cho, Kim, and Yang: A Case of Development of Vitiligo Followed by TNF-α Antagonist Treatment for Rheumatoid Arthritis
Case Report
Journal of Rheumatic Diseases

Journal of Rheumatic Diseases 2012; 19(4): 216-219.

Published online: 31 August 2012

DOI: https://doi.org/10.4078/jrd.2012.19.4.216

A Case of Development of Vitiligo Followed by TNF-α Antagonist Treatment for Rheumatoid Arthritis

Ran Song1, So-Mi Kim1, Sang-Hoon Lee1, Yeon-Ah Lee1, Seung-Jae Hong1, Hee-Ryung Cho2, Gou-Young Kim3, Hyung-In Yang1

1Division of Rheumatology, School of Medicine, Kyung Hee University, Seoul, Korea.

2Division of Dermatology, School of Medicine, Kyung Hee University, Seoul, Korea.

3Division of Pathology, School of Medicine, Kyung Hee University, Seoul, Korea.

Corresponding to: Ran Song, Division of Rheumatology, School of Medicine, Kyung Hee University, 892, Dongnam-ro, Gangdong-gu, Seoul 134-727, Korea. happiran@paran.com

Received 9 September 2011       Revised 12 October 2011       Accepted 12 October 2011

Copyright © 2012 by The Korean College of Rheumatology

(free-access):

This is a Free Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

As the usage of biologics for rheumatic diseases increases, such as rheumatoid arthritis and ankylosing spondylitis, various cutaneous adverse events are also being increasingly reported. We experienced a case of development of vitiligo during a TNF-α antagonist therapy in a 22-year-old woman with rheumatoid arthritis. The patient was presented with vitiligo lesions on the dorsum of both hands after 1 month of treatment with etanercept. Vitiligo improved with topical tacrolimus ointment and excimer laser treatment without the discontinuation of etanercept. No clearly defined mechanism for vitiligo induced by TNF-α antagonist exits. However, considering that vitiligo is an autoimmune disorder, the development of this skin lesion in association with the TNF-α antagonist could be explained by a paradoxical induction of the autoimmune process.

Keywords: Rheumatoid arthritis, TNF-α antagonist, Vitiligo

Figures and Tables

Figure 1
Well-defined depigmented white patch on dorsum of hand following etanercept therapy.
jrd-19-216-g001
Figure 2
Decreased basal pigmentation and loss of melanocytes in basal layer of epidermis are noted (H&E, ×200).
jrd-19-216-g002
Figure 3
Immunostaining for melanocytes reveals loss of expression of S-100 protein (Polymer method, ×200).
jrd-19-216-g003

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